Agarwal Anil, Gulati Divesh, Rath Suman, Walia Mandeep
Department of Pediatric Orthopedics, CNBC, Delhi, India.
Indian J Pediatr. 2009 Mar;76(3):269-72. doi: 10.1007/s12098-009-0052-y. Epub 2009 Apr 6.
Children with complaints of not able to walk were investigated for rickets by appropriate history, clinical examination, serum biochemistry and radiology.
Children more than 1 yr were included. Each child was evaluated keeping in mind the possible causes of delayed walking. Also each child was thoroughly examined and diagnosed by combination of clinical, radiological, biochemical findings and response to treatment.
Out of forty-two non-walkers during the study period, 25 patients turned out to be affected by nutritional rickets (60%). On follow-up at 3 weeks of treatment, all 25 patients (100%) showed radiological and biochemical response. Five patients were lost to follow-up after 3 weeks of treatment. Seventeen patients started walking within 3 months of treatment. Two patients did not start walking even after complete biochemical and radiological resolution. Radiological resolution, with limiting factor being the healing of lower end of ulna, averaged 5 months.
The study reveals that majority of ricketic non-walkers start walking within 2 to 5 months of appropriate treatment.
通过适当的病史、临床检查、血清生化检查和放射学检查，对主诉不能行走的儿童进行佝偻病调查。
纳入1岁以上儿童。评估每个儿童时考虑到行走延迟的可能原因。此外，通过临床、放射学、生化检查结果及对治疗的反应对每个儿童进行全面检查和诊断。
在研究期间的42例不能行走的儿童中，25例患者被诊断为营养性佝偻病（60%）。在治疗3周后的随访中，所有25例患者（100%）均显示出放射学和生化反应。5例患者在治疗3周后失访。17例患者在治疗3个月内开始行走。2例患者即使在生化和放射学完全恢复后仍未开始行走。放射学恢复平均需要5个月，限制因素是尺骨下端的愈合。
该研究表明，大多数患有佝偻病而不能行走的儿童在适当治疗的2至5个月内开始行走。
